Posted on 10/30/2013 12:31:14 PM PDT by CriticalThinking
....So, If I don’t buy any insurance, I save $6,360. The risk is, something big happens. But if that does, then I can immediately buy insurance to cover it. The new insurance won’t start the deductible process until I purchase it. Which basically means if my wife or I get really sick, buy the insurance before costs exceed something between $0 and $6,360. This is sort of our personal actuarial process. But each year, we save the money so that break even point will change. To be fair, the penalty goes up to 2% in 2015, so the savings will be $4,560 then. Given the actuarial nature of ACA, premiums are likely to go up because ACA mandates a reduction of the deductible. What this all means is the “Don’t buy insurance” plan works fine for the next few years but maybe not forever.....
(Excerpt) Read more at 4yourcountry.org ...
Well they can try to demand the deductible upfront but they still have to treat you emergently if you say..”it’ll have to wait until payday; but you still are required to treat me emergently under federal law...just like those Mexicans I see in the waiting room!
Paying for cash or credit to handle the expense until then pretty much defeats the whole purpose of insurance.
A relative had meningitis in August 2010, which resulted in a stroke while being treated. By the time the next year rolled around, he had racked up a $450,000 hospital bill.
Then we’ll need to plan our heart attacks accordingly. I wish I had planned mine a little better.
You forgot the 300 pound sweaty husband.
If you don't buy insurance you'll have to pay an additional 1% for every year you're not covered... forever. Or something like that... They do a similar thing with medicare now...
I suspect dems left off a lot of stuff that would make people balk (even more than they are now) at the law... it'll all be added later. But until then your plan seem solid... Well unless you have a crisis - like a heart attack - and the hospital bill is close to $100,000 BEFORE you can get sighed up... I guess the old catastrophic insurance isn't available anymore...
What's to prevent everyone from saying they make $20K thus qualifying for the subsidies?
Has anything been more retarded than this ??
The law is that a hospital cannot refuse treatment in an emergency. Otherwise, they can and do refuse treatment.
Fair point. Let me re-suppose you’re both injured in a non-automotive accent or overcome by an illness.
I love it when smart people who actually have a clue, as opposed to the people who wrote or voted for ACA, analyze the situation and come up with an answer like the one in this article. Nothing would be better but to have everyone not buy insurance and simply buy insurance when they get sick. Beautiful!
JoMa
I can solve that the same way any 100 pound baby mama could.
Why?
A relative had meningitis in August 2010, which resulted in a stroke while being treated. By the time the next year rolled around, he had racked up a $450,000 hospital bill.
I'm pretty sure the $450,000 figure has been inflated several times as the story has been passed along.
I had a contractor working on a job and his wife had to have her spleen removed. He didn't have insurance and after talking with the hospital he paid about $20,000 on a payment schedule.
I went in last summer with trauma from about 16 dog bites. My insurance was taken at the front window before I was admitted into the ER proper. I was bleeding, in pain and my arm was obviously mauled, already showing bruising and of limited use.
Of all the staff (MD, RN, LPN, Nursing Assistant), only the little old assistant even touched my arm or got within 3 feet of my wounds. RN and LPN came in and looked at the monitors. RN offered tetanus and morphine, of course in the opposite arm. Assistant soaked towels in an antiseptic specifically listed on the label as inappropriate for puncture wounds, then placed an ointment similarly labeled on gauze squares and placed them over the wounds and then bound the arm in gauze. No one checked her work at closer than a 3-foot glance after it was wrapped. MD prescribed a form of penicillin I have had experience with. It tears up my gut and I don’t tolerate it. I told him this. He substituted Doxycycline and was not happy when I refused his vending machine doxcy in favor of Walmart. MD did do nerve tests (finger resistance) and determined I had no permanent damage. He prescribed codeine+Tylenol for pain.
I went home, cleansed the wounds by immersion in water w/Epsom salts, irrigated w/saline, applied silver sulfadiazine (with some help), called my physician who nixed the doxcy and prescribed something stronger that works on deep wounds. My take home instructions made no mention of soaking or gentle irrigation. I was there one hour.
Charges were $1k. Medicare paid minimally and my supplement paid about $275. I suppose they ate the rest, as I received no bill. About 6 months later, I heard through the grapevine (no employees would comment) the MD was escorted out by uniformed officers one day, never to return. This is the 2nd ER doc to be fired that I know of in the past year. I have lived here over 40 years, know clinicians and am aware of only two firings, both for high morbidity, in that time. Small regional hospital, under the auspices of giant regional medical center, 4-6 bay ER with adjoining exam rooms, 3-4 clinics, full availability of imaging, labs, pharmacy,specialties, 6 beds, maybe a total of 20 MDs, one a world-famous orthopod known for the invention of an elbow operation.
I received better, more appropriate treatment 17 years ago when I went in with a cracked metatarsal. I have heard similar and worse anecdotal reports from others, all of whom, along with me, have had complete faith and trust in this hospital, the clinics and the clinicians in the past.
I guess it depends on what the definition of stabilization is.
Two points; one, hospitals are businesses, they will negotiate and will not deny treatment in life or death situations; Two, you can find policies that are for catastrophic events if you look for co-ops.
Co-ops have been exempted from obamacare.
errata:
No one checked her work at closer than a 3-foot glance after it was wrapped.
should be:
No one checked her work at closer than a 3-foot glance UNTIL AFTER after it was wrapped.
No, I received the bill. Medicare only paid about 15% of that bill. And they wrote off the rest. And that's one of the things that's wrong with medicine today. The old antitrust laws should apply that they can't charge a different rate for the same service.
Not exactly. The ER is required to provide a screening medical exam, and stabilization of any emergent medical condition. So if you show up with a non emergent condition they gave every right to do the screening then show you the door.
So actual payment was about $67,500.
And they wrote off the rest.
I would suggest they never expected the difference. Hospitals negotiate everything. We don't see it if an insurance company is handling the bill, but if you tell them I can't pay that amount they will negotiate. I would point you back to the example of the contractor as an example.
If its not an emergency, then I am not sure why you are at the ER or why you need to worry about immediate treatment. More and more doctors are willing to take cash at a discount as are urgent care facilities. Frankly in many socialized countries there is a whole tier or private clinics that provide the real high quality care. No one in their right mind would go to the hospital in some of those locations.
Well, we can resuppose until the cows come home. Bottom line is that everyone’s situation is probably some different.
Certainly one needs to look at all the insurance they carry - auto, home, disability, some self-employed people carry disability insurance that pays if they aren’t able to perform their normal tasks, etc., what’s the cash reserve, how close is the nearest clinic, do you have a personal physician, what is the cost of an office visit, what is the age of the people and what is the extent of the medical intervention they would want - regardless of whether they had insurance or not, what are the resources in the community where you live.
My need for extensive and expensive insurance at my age is significantly less than that of my son who has a young child. No situation is just black and white and no two families are alike, in spite of what Obama and the government think.
Negotiation pretty much has to occur on the front end. They may accept less if you can’t pay, on the back end, but I wouldn’t account on it.
They need to get back to where they charge the same price for the same procedure for everybody regardless of insurance. Only then will we have some clarity.
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